Co-founding the groundbreaking magazine Ms. in 1972, Ms. Steinem and her colleagues brought feminist issues to the forefront.
“For the first time, there are fewer females on Earth than males because of all the forms of violence,” Ms. Steinem said at UN Headquarters in 2016 to draw attention to violence against women.
Gloria Steinem: The link between women’s rights and peace
Ahead of UN Women’s 16 Days campaign against gender-based violence, take a front row seat for a look at some of Ms. Steinem’s work here, part of the UN News #ThrowbackThursday series showcasing epic moments across the UN’s past. From the infamous and nearly-forgotten to world leaders and global superstars, stay tuned for a taste of the UN Audiovisual Library’s 49,400 hours of video recordings and 18,000 hours of audio chronicling.
Visit UN Video’s Stories from the UN Archive playlist here and our Podcast Classics series here. Join us next Thursday for another dive into history.
The salinity of the water in coastal Bangladesh contributes to high blood pressure. Credit: Rafiqul Islam/IPS
by Rafiqul Islam (dhaka)
Inter Press Service
DHAKA, Nov 07 (IPS) – Since her childhood, Parveen Begum, 52, has been adding extra salt while eating her meals. However, she did not know that this contributed to high blood pressure.
Recently, she suffered severe headaches, forcing her to go to a physician, and when the doctor checked her health, he she had hypertension.
“I could not take my daily meals without taking additional salt, which helped develop the chronic disease in my health. Now I have to take medicines for blood pressure regularly, putting an extra financial burden on my family,” said Parveen, a resident of Musapur at Raipura in Narsingdi district.
Rabeya Begum, 50, is a resident of the saline-prone Ashabaria village of Rangabali in the Patuakhali coastal district. Like many others, she and her family members often drink saline water since freshwater sources are affected every year due to coastal flooding, cyclones, and storm surges. Salinity instruction has reached the aquifer in her locality.
Local people face scarcity of drinking water during the dry season as salinity reaches an acute level that time, so they are compelled to drink saline water, Rabeya said.
“I felt symptoms of high blood pressure like headache and chest pain. So, I checked it and found blood pressure. But there are not enough facilities for screening blood pressure in our remote village,” she said.
Like Parveen and Rabeya, a huge number of people have been suffering from high blood pressure, also called hypertension, in Bangladesh, but most of the cases remain undiagnosed. High blood pressure is a chronic disease and a silent killer, too.
Hypertension or high blood pressure develops when the pressure level in one’s blood vessels reaches 140/90 mmHg or higher. A healthy lifestyle, quitting tobacco, and remaining more active can help lower blood pressure.
According to the World Health Organization (WHO), around 1.28 billion adults aged 30–79 years worldwide have hypertension, with two-thirds of them living in low- and middle-income countries. An estimated 46 percent of adults with hypertension are unaware of their condition. Only less than half of adults (42 percent) with hypertension are diagnosed and treated.
Undiagnosed Hypertension
Undetected high blood pressure could add to the health burden in Bangladesh. Many people are not on medication as they are unaware of their condition. According to a survey, more than half of hypertensive patients are ignorant of their condition.
Experts say early identification and improved hypertension screening can reduce the high global burden of untreated high blood pressure.
According to a 2022 study, hypertension is common in elderly people, and undiagnosed hypertension increases with age. The risk of undetected hypertension was high among people aged 33–35. Overall prevalence of undiagnosed hypertension among men and women was similar. Men aged above 50 had lower levels of awareness and participation in early detection initiatives.
The study revealed that the prevalence of hypertension is significantly higher among the residents of Bangladesh’s coastal and eastern regions.
It suggested that early detection and screening are urgent for checking the prevalence of undiagnosed hypertension. The study suggested the authorities should take robust health promotion measures in the coastal and northern regions of Bangladesh.
Dr Mahfuzur Rahman Bhuiyan, programme manager of the High Blood Pressure Control Programme at National Heart Foundation Hospital and Research Institute, said it would be possible to reduce the risk of high blood pressure by 50 percent if people avoid the intake of extra salt while taking meals.
He recommended screening people to identify those with high blood pressure.
Hypertension Amplifies Risk of Heart Diseases
Hypertensive heart disease is a long-term condition that worsens with time. In Bangladesh, around 68 percent of deaths are caused by non-communicable diseases, with hypertension accounting for 15–20 percent.
According to the first Global Report on Hypertension 2023, released by the WHO, about 273,000 people die of cardiovascular diseases each year in Bangladesh, while around 54 percent of these fatalities are attributable to hypertension.
The report also reveals that half of the people having hypertension are not even aware of their condition, and the rate of those receiving medical treatment for hypertension is alarmingly low, merely 38 percent.
“Hypertension is one of the leading causes of deaths associated with non-communicable diseases. The prevalence of heart diseases can be reduced to a great extent by keeping hypertension under control,” Prof Sohel Reza Choudhury, Head of the Department of Epidemiology and Research at the National Heart Foundation, told a webinar recently.
National Professional Officer at WHO Bangladesh Office Dr Farzana Akter Dorin, suggested strengthening the primary healthcare system and ensuring free hypertension medicine to cut the risk of developing heart diseases among people.
Keithlin Caroo speaks to young Saint Lucian on International Rural Women’s Day. Education is an important part of advocacy on behalf of women and girls. Credit: Alison Kentish/IPS
by Alison Kentish (saint lucia)
Inter Press Service
SAINT LUCIA, Nov 03 (IPS) – Amid fears that global shocks like the COVID-19 pandemic have eroded progress toward gender equality, the Commonwealth Foundation has created an online platform that takes civil society’s recommendations for the empowerment of women and girls directly to policymakers.On August 22, 2023, Women’s Affairs Ministers from the Commonwealth huddled in a room at the Atlantis Resort in the Bahamas. For the first time since the COVID-19 pandemic, they were meeting in person.
The 13th Commonwealth Women’s Affairs Ministers Meeting was being held under the theme, Equality Towards a Common Future. It was taking place amid the acknowledgement by policymakers that issues like accelerating climate change, economic turmoil, political upheaval in some parts of the world, and the COVID-19 pandemic have taken a debilitating toll on progress toward the empowerment of women and girls.
Bahamian Prime Minister Philip Davis vowed that the gathering would be solutions-oriented.
“The time is now for our Commonwealth community to be unabashedly ambitious in our goals and plans. We need more than slogans – we need commitments,” he said.
As Dr Anne Gallagher, Director General of the Commonwealth Foundation, addressed the high-level forum, images of a recent online civil society gathering organized by the Foundation flashed on screens across the room. The key outcome of that event was a list of ten recommendations that civil society groups from across the Commonwealth want women’s affairs ministers to consider.
Recommendation number seven, “Measure better to target better,” appeared on the screen. It was one of the recommendations that drew animated discussion among delegates. It came from a young woman dedicated to helping women farmers in her part of the world.
The journey of a recommendation from an online forum to the Commonwealth’s highest decision-making body for women’s affairs is serving as an example of the importance of not just giving a voice to those who are on the ground, working with women and girls but ensuring that their concerns are heard by those charged with gender equality policy action.
A Virtual Roundtable
Keithlin Caroo was a panellist on the Commonwealth Foundation’s Critical Conversations series, a virtual discussion that seeks to find sustainable solutions to the most pressing issues for the 2.5 billion citizens of the Commonwealth.
For years, Caroo has been on a mission to help rural women in her home country, Saint Lucia, and has extended that support to the neighboring islands of St. Vincent and the Grenadines and St. Kitts and Nevis. She is the founder and executive director of Helen’s Daughters, a non-profit organization that she refers to as a ‘community,’ which has been changing the narrative on women in agriculture. Helen’s Daughters is built on the premise that while in small states, everyone is connected to agriculture, women are not sufficiently supported despite their pivotal role in the sector.
The organization helps rural women with market access and forges linkages for farmers with supermarkets, restaurants, hotels, and the public through a FarmHers Market. It runs a free Rural Women’s ‘Ag-cademy’ on the islands of Saint Lucia, St. Kitts and Nevis and St. Vincent and the Grenadines, which focuses on sustainable agriculture and entrepreneurship. It is the first all-women agri-apprenticeship programme in the Caribbean. The organization operates a structured care system that focuses on the holistic development of women, hosting training on trauma-informed care to peer-to-peer support and wellness retreats.
Before the virtual event, the Commonwealth Foundation had made it clear – recommendations from the forum would be put before decision-makers. When Caroo spoke, she did so on behalf of the women farmers who toil daily in a sector fraught with gender biases.
“This engagement was important because it shows that the voices of grassroots organizations are important to Commonwealth’s policymaking; however, what’s important for me is seeing to it that the recommendations translate from policy to actions on the ground,” she said in an interview with IPS.
“We recognized the lack of sex-disaggregated early on, and aside from our interventions, data collection, monitoring, and evaluation are key to our work. Lack of data places further burden on us because aside from crafting interventions relevant to our beneficiaries, we are also responsible for primary data collection, which takes more time and resources; however, we must craft interventions according to the current state of play rather than what is imagined. As I said during the roundtable- “We can only target better if we measure better.”
Voices like Caroo’s played an important role in ensuring a commonwealth-wide response to gender inequality.
The Process
With its theme Gender, climate change and health: how can we do better for women and girls? the virtual roundtable stoked discussion on cross-cutting issues such as violence against women, investing in women and access to education.
“The event was deliberately outcome-oriented: it included not just a debate and discussion but also a highly focused working session where all participants were charged with coming up with specific recommendations to present to this body. Not a shopping list of blue-sky ideas but practical steps that they felt reflect what Commonwealth civil society – what the 2.5 billion citizens of the Commonwealth, want their countries to do for women and girls when it comes to health and climate change,” said Gallagher.
She reminded the gathering that the Foundation is a link between Commonwealth Member States and the people they all serve. She urged the ministers to reflect on the ‘clear and urgent’ recommendations from civil society.
“For me, the clarity and simplicity of the ten recommendations signals an important truth: we all understand the challenges we are up against in relation to women’s rights and well-being, and also in relation to climate change. We all appreciate what must be done. But shifting the current trajectory in ways that make a real difference will require much more. It will require courage, commitment, and true solidarity within and between countries of the Commonwealth,” she said.
The Recommendations
Recommendation seven, “Measure better to target better,” might have struck a chord with attendees, but the other nine recommendations were also well received.
They are:
Acknowledge that the impacts of the climate crisis are not gender-neutral,
Empower women through gender-responsive climate policies and actions,
Improve access to education and training for women and girls,
Improve climate finance and bring women forward as leaders and decision-makers,
Value and promote women and girls as adaptation educators and agents of change,
Promote gender equality in access to healthcare
Act to reduce gender-based violence
Enhance women’s economic empowerment.
The meeting’s official outcome statement notes that the recommendations were welcomed and endorsed.
Their journey is not over – they are now part of the women’s affairs ministerial meeting recommendations that will be brought before Commonwealth Heads of Government at their 2024 meeting in Samoa.
“I thought this engagement was of particular importance because I had never been to a panel at this level that spoke on the intersection of gender, climate change and health or intersectionality in general. Far too often, we focus on these themes in silos,” Caroo said.
“We do not consider Helen’s Daughters an agricultural organization because we deal with gender, climate change, gender-based violence, health, economic empowerment, climate and environmental justice, several areas that contribute to the overall development of our FarmHers. I thought the roundtable was timely because our policymaking needs to take an intersectional approach.”
They issued a statement expressing shock over the death of Armita Geravand, the teenager who collapsed in the subway in Iran’s capital, Tehran, earlier this month, allegedly following an altercation about failing to wear a headdress or hijab.
Ms. Geravand died on Saturday, according to international reports which cited State media. The experts called for an independent, prompt and impartial investigation into her death, noting that the Government maintains that she suffered brain damage from her fall.
“Women and girls should not be punished for wearing or not wearing any specific piece of clothing and should certainly not be at risk of losing their lives for doing so,” they said.
Parallels with Mahsa Amini
Their statement reiterated concerns previously expressed to authorities in Tehran about the imposition of a dress code on women and girls, and the use of excessive and unlawful force against those who do not comply.
This followed the redeployment of Iran’s so-called “morality police” since the end of July, after the introduction of the Chastity and Hijab Law, which several UN experts are concerned is incompatible with the principles of gender equality and other fundamental freedoms.
“We are dismayed at the parallels between the circumstances of Jina Mahsa Amini’s death and more recent deaths,” the experts added.
Ms. Amini, 22, was arrested in Tehran in September 2022 for her alleged failure to comply with the already strict hijab law and later died while in custody.
Failure to investigate
The experts also expressed grave concern and disappointment at the failure of the authorities to conduct independent investigations into the deaths of women and girls during the nationwide protests sparked by her death.
“We are aware of reprisals against other women, including celebrities, for refusing to comply with the mandatory dress code,” they said.
“Even before the law was passed, there were increasing reports of women facing legal action for violating the dress code. Some have lost their jobs or been sentenced to jail, while others have been ordered to perform forced labour.”
Abolish dress codes
The experts urged the Iranian authorities to amend the Constitution; repeal existing gender discriminatory laws, including regulations imposing compulsory dress codes, and abolish all regulations and procedures whereby women’s dress or behaviour in public or private are monitored or controlled by State authorities.
“We remain concerned and alarmed by the ongoing policies and practices in Iran which amount to total impunity for acts of gender persecution against women and girls and urge the Government to put an end to them,” they said.
Addressing the Council’s annual debate on resolution 1325, he appealed for countries to “urgently bridge the gap between rhetoric and reality” through concrete action in the areas of participation, financing and leadership.
“Of 18 peace agreements reached last year, only one was signed or witnessed by a representative of a women’s group or organization,” he said. Women also comprised just 16 per cent of negotiators or delegates at UN-led, or co-led, peace processes, he added.
War’s impact on women
Mr. Guterres highlighted how women’s contributions are needed in a world that is on a “knife’s edge” due to raging conflicts, escalating tensions, coups, rising authoritarianism, climate chaos, the nuclear threat, and other crises.
“Where wars rage, women suffer. Where authoritarianism and insecurity reign, women and girls’ rights are threatened. We see this around the world,” he said, pointing to situations in Afghanistan, Haiti, Sudan, Ukraine and the recent escalation in the Middle East.
“Women and girls are among the many victims of Hamas’ brutal atrocities,” he told the packed Council chamber.
“And women and children are more than half the victims of the relentless bombing of Gaza. Tens of thousands of pregnant women are desperately struggling to access essential healthcare.”
Shut out and fed up
Mr. Guterres called for the women, peace and security agenda to be fully implemented now “because women have had enough of being shut out of the decisions that shape their lives”.
Women are demanding concrete actions, he continued, with the first step being ensuring their presence in peace talks. He encouraged governments to support conflict mediation to set ambitious targets for women on negotiating teams.
The UN chief also underscored the need for “money on the table”, stating that “if we want to stand with women driving change, if we want to support women enduring conflict, if we want to remove barriers to participation, and if we want women’s organisations to deliver, we need to pay for it.”
A UNICEF expert on sexual exploitation and abuse briefs displaced people at a gathering point in Wad Madani in east-central Sudan.
Funding and fair representation
He urged countries to allocate 15 per cent of their overseas development assistance to gender equality, and a minimum of one per cent to women’s organizations mobilizing for peace. Fifteen per cent of funding for mediation must also support women’s participation.
Finally, women must have full, equal and meaningful participation at all levels of decision-making on peace and security, and in political and public life.
“That means pushing fair representation in national and local governments, cabinets and parliaments,” he said.
He further called for “robust, comprehensive legislation” to combat violence against women, whether online or in real life, and to end impunity for perpetrators.
600 million in conflict areas
Sima Bahous, Executive Director of UN Women, presented the Secretary-General’s latest report on resolution 1325, which reveals that last year, 600 million women and girls were living countries affected by conflict – a 50 per cent increase since 2017.
She also focused on the current crisis in Israel and Gaza, where women and children on both sides have been killed.
UN Photo/Eskinder Debebe
Sima Sami Bahous, Executive Director of UN Women, addresses the Security Council meeting on Women’s Participation in International Peace and Security.
Middle East crisis
Many women and children were among the more than 1,400 Israelis killed by Hamas, and women are among the roughly 200 hostages seized by the militants. More than 6,000 people have been killed in Gaza, 67 per cent of them women and children.
UN Women estimated that there are now more than 1,100 new female-headed households in Gaza, while upwards of 690,000 women and girls have been displaced.
“But let me be clear – every act of violence against women and girls, including sexual violence, is unequivocally condemned irrespective of the nationality, identity, race or religion of the victims,” she said.
Wins and warnings
The UN report reflects a decline in women’s meaningful participation across the peace spectrum, but it also provides examples of what has worked, especially at the local level.
Ms. Bahous listed examples of women’s achievements, including leading successful crossline negotiations to secure access to water and humanitarian aid, brokering the release of political prisoners, preventing unresolved tribal conflicts and mediating local ceasefires.
Women’s participation in UN Peacekeeping also increased in the past year. These “blue helmets” have set up mobile courts to convict perpetrators of gender-based violence, helped to secure the release of women and girls abducted by armed groups and other achievements.
“These examples should inspire us,” she said, while warning that as peace operations withdraw from countries, the UN’s capacity to monitor and protect women’s rights becomes more limited.
An interactive exhibition mounted outside UN Headquarters in New York gives life to the subject of the Security Council meeting.
The 50 large portraits of women peacekeepers and peacebuilders provide a powerful reminder of the urgent need for more action to ensure women are included in efforts to end conflict and build lasting peace.
UN Photo/Manuel Elías
Mirjana Spoljaric Egger, President of the International Committee of the Red Cross, briefs the UN Security Council meeting on Women’s Participation in International Peace and Security.
Gender aspects of conflict
The President of the International Committee of the Red Cross (ICRC) also briefed the Council, saying developments in the Middle East and elsewhere were “a shocking reminder of how rapidly humanitarian conditions can deteriorate.”
Mirjana Spoljaric Egger urged warring parties to “maintain a minimum of humanity” and adhere to international humanitarian law, which upholds the equal protection of civilians, combatants, prisoners of war and those wounded in hostilities.
She drew attention to the gender aspects of conflict, a subject she had raised in a previous address to the Council, noting that “many violations against women go undocumented and continue to be considered an inevitable side effect of war.”
She called for action to prevent and address sexual violence, promote accountability, and to ensure it is always designated as a war crime under international law.
No women, no peace
The ICRC has also been working with legal and military experts to understand how military operations impact women and girls differently, as they often are the ones caring for children, the sick and the elderly, thus affecting their ability to flee danger.
Finally, the Red Cross “sees every day” how women’s meaningful participation in both economies and societies benefits communities as a whole and improves prospects for peace.
“There are 100 steps to peace, and the first are always humanitarian,” said Ms. Spoljaric Egger.
“Without direct input from women, without the recognition of the gendered impact of armed conflict on women, and without the acknowledgement of women’s roles in all aspects of their society, peace responses will fall short and therefore lack the prospect for truth, stability and security.”
UN Photo/Eskinder Debebe
Glivânia Maria de Oliveira, Director General of the Rio Branco Institute, briefs the UN Security Council meeting on Women’s Participation in International Peace and Security.
Hope from Colombia
Brazilian diplomat Glivânia Maria de Oliveira brought positive news from Colombia, where women participated in the negotiations between the Government and the largest remaining rebel group in the country, ELN, which led to a six-month bilateral ceasefire that began in August.
Ms. de Oliveira represented her country at the talks, noting that “more women were also present as builders and promoters of peace.”
She recalled that earlier negotiations between the Colombian authorities and the FARC rebel group, which ended some 50 years of conflict, also had a “gender dimension” that was further reflected in their 2016 Peace Agreement.
In conclusion, she paid tribute “to the courageous Colombian women who have faced the horrors of violence and pain and loss”, and to the women delegates at the
Addressing the UN-backed body meeting in Rome on Monday, António Guterres underscored that the session was taking place “at a moment of crisis for global food security” and provided some sobering statistics.
“Last year, 735 million people went hungry. More than 3 billion cannot afford a healthy diet,” said the Secretary-General in a video message, adding that “we are going backward on our goal of zero hunger by 2030.”
He emphasized that hunger and malnutrition were not just problems but human rights violations “on an epic scale”, painting a vivid picture of the dire consequences of the rolling crisis.
“When nutritious food is out of reach because of cost or geography; when bodies are eaten away by hunger; when parents watch helplessly as their children suffer and even die from a lack of food”, this is nothing less than “a human tragedy – a moral catastrophe – and a global outrage,” Mr. Guterres stated.
All about access
The Secretary-General made it clear the world has the resources to address this crisis. “There is more than enough food to go around. And more than enough resources to ensure that every person on the planet has enough to eat.”
He emphasized the role of governments in ensuring access to nutritious food, saying that while they have a responsibility to provide it, many governments lack the resources to do so.
António Guterres called for effective international solidarity to transform food systems for all people.
For that, explained the UN chief, massive investment, innovation, science, and technology are essential – to build “sustainable food systems in harmony with nature and addressing the climate crisis.”
Thinktank on food supply
He commended the work of the CFS – which includes staff from the Food and Agriculture Organization (FAO) and World Food Programme (WFP) – emphasizing its importance in finding solutions.
“Your Committee’s work is critical to this process. From reimagining agrifood systems, to boosting the collection and use of data, to ensuring that the needs of women and girls are at the heart of all that we do.”
The Secretary-General implored the world to prioritize this fundamental human right: “Let’s give the fundamental human right to food the investment and urgent action it deserves.”
Established in 1974, the Committee on World Food Security was reformed in 2009 to become an inclusive international and intergovernmental platform tasked to ensure food security and nutrition for all.
Temperatures have already started to drop into single figures.
With about two-thirds of the affected areas assessed, more than 21,500 homes are confirmed destroyed and a further 17,000 severely damaged, according to the UN humanitarian affairs coordination office (OCHA). Over 154,000 people have been impacted.
Critical psychosocial support
That number includes about 7,500 pregnant women, many of whom lost family members.
The deaths of their loved ones has taken a devastating toll, the UN Population Fund (UNFPA) said.
The agency has deployed psychosocial counsellors to help them cope with overwhelming loss.
“They need someone to listen to them and help them cope with their trauma,” said counsellor Faiza Zarie, adding that the availability of psychosocial support is critical.
Women also face other challenges – heightened risks of preventable maternal death, gender-based violence and hunger.
UNFPA is working to address reproductive health needs. It issued a funding appeal for $11.6 million to continue delivering life-saving sexual and reproductive health supplies and services.
Health facilities, workers affected
Access to medical care has also been severely affected, with at least 40 facilities reported damaged, a region that was already largely deprived of essential health services before the disaster.
The World Health Organization (WHO) warns that services for about 580,000 people have been severely disrupted.
“Health workers are also affected by the disaster – either from loss of family members or from fear of collapsing health facilities, which makes it even harder for them to provide the health care their communities need,” Alaa AbouZeid, WHO team leader emergencies in Afghanistan, told reporters in Geneva, from Kabul.
“The health consequences are staggering,” she added
The UN agency has been one of the first responders on the ground, supporting hospitals with medicines and supplies and organizing mobile health and nutrition teams.
Sustaining health services will require extra resources, and WHO and partners have launched an appeal for $7.9 million to provide support for the next six months.
Countries attending the landmark Conference, held in Cairo, agreed a Programme of Action which promised that women and girls must have the power to make decisions about their own lives, their bodies and their futures.
Mr. Türk commended the “leaps” made during the past three decades which include a reduction in deaths during pregnancy, and “substantial investments” in healthcare, education and social services. Many people are also living longer, healthier lives.
“But this is an unfinished agenda,” he said. “Alongside the progress, we have seen regression.”
Backlash and toxic masculinity
Mr. Türk pointed to “patchy implementation” of the principles laid out in the Programme of Action in many parts of the world.
“Gender equality backlash is spreading, denying women and girls autonomy, the capacity to choose their futures or their roles within families and households, and silencing their voices,” he said. “Toxic masculinity – and misogyny – have inflamed and normalised hate.”
Additionally, COVID-19, conflict and economic downturns have also disproportionately affected women and girls. Meanwhile, “babies don’t stop being born during conflict or disaster, and people still get pregnant.”
WHO/Occupied Palestinian Territory
Al-Shifa Hospital in Gaza. WHO warns that hospitals in the Gaza Strip are at a breaking point.
Pregnancy under fire
Today, roughly 50,000 women are pregnant in Gaza, where health services are currently under attack.
The earthquake in western Afghanistan this month has rendered pregnant women there even more vulnerable, while women and girls in Ukraine still need access to life-saving sexual and reproductive health services.
Furthermore, in 68 countries, an estimated 44 per cent of women who are married or partnered do not have the ability to make their own decisions on sexual relations, use of contraceptives, and healthcare.
“Women’s right to decide – free of discrimination, coercion and violence – if and when to have children, how many and with whom, needs to be guaranteed,” he said.
“This is all the more the case as progress on maternal mortality has stagnated in the last decade. Every two minutes, a woman will die due to complications in pregnancy and childbirth.”
Against unsafe abortion
He remarked that “perhaps nowhere is a woman’s autonomy and ability to make her own choices about her body and life more hotly contested than when she seeks to access safe abortion services.”
Roughly 33 million unsafe abortions are conducted globally each year, he said, and it is one of the leading causes of maternal mortality. He welcomed action by many countries in the last five years to liberalize legislation, whether through decriminalization, expanding legal grounds for it, or removing access barriers.
Keep Cairo promise
Mr. Türk said human rights reversals of all kinds are accelerating around the globe, putting countries offtrack to achieve sustainable development and the ICPD Programme of Action, but it is not too late to course correct.
His Office is working with States to bolster their efforts towards “a human rights economy”, which puts people and the planet at the heart of all policies, plans and programmes.
“To change lives, and to save lives, we need to ensure the fundamentals promised in Cairo thirty years ago are upheld – for all women and girls, no matter their age, their migration status, or any other factor,” he said.
He outlined what they need, namely comprehensive sexuality education; access to modern forms of contraception, including emergency contraception; access to quality sexual and reproductive health services, including safe and timely abortion services and maternal and newborn care, and the freedom to make their own choices.
Community health workers demand to be recognised as formal workers with pay and benefits to match. Credit: Zofeen T. Ebrahim
by Zofeen Ebrahim (karachi)
Inter Press Service
KARACHI, Oct 19 (IPS) – “Professionally, I am still where I was 23 years ago when I started working as a lady health worker (LHW),” said a disgruntled Yasmin Siddiq, 47, from Karachi. “I will probably retire in the same capacity, as a Grade 5 government servant, without any hope for upward mobility.”
The idea behind the Lady Health Worker Programme (LHWP), the brainchild of Pakistan’s late prime minister Benazir Bhutto, began in 1994 with the purpose of “training women as community health workers (CHWs) to improve the dismal maternal and child health scores of the country and build a bridge between the village woman and the formal health sector,” said Dr Talat Rizvi, a public health physician with a vast experience in Maternal and Child Health with a particular focus on community-based projects and who designed the programme.
Siddiqi’s day starts at 9 am, and she must go door-to-door, covering between 5 to 10 homes within the 1 km radius of her home. “Initially, my tasks included making married women (of reproductive age) aware of the benefits of family planning and informing and providing them assistance about contraceptives, ensuring they go for antenatal check-ups when pregnant and their tetanus shots. I had to keep an eye on under-five children of that family and get them vaccinated,” she said. Over the years, her workload has expanded.
“We were asked to help fight TB, handle refusals by parents on administration of polio drops, ensure every child under five gets immunised against childhood diseases, which have now increased to 12 vaccines, and recently during the COVID-19 pandemic, we helped with vaccinations,” said Bushra Bano Arain, chairperson of All Pakistan Lady Health Workers Union. “And as if health is not enough, we are asked to carry out our duties on election day,” disclosed Arain, an LHW supervisor.
“Over the years, the focus got diluted from primary healthcare when more and more responsibilities were added to the LHWP’s boat, and the boat sank,” said Rizvi.
“The original programme of ensuring the health of mother and child took a backseat,” agreed Dr Shershah Syed, a gynaecologist and obstetrician. “LHW was perhaps started with good intention but had become a politicised entity with many women recruited by MPAs and MNAs as ghost workers, in the Sindh province especially,” he added.
The situation is no better for the over a million Accredited Social Health Activists (ASHAs) in India or the 52,000 Female Community Health Volunteers (FCHVs) of Nepal, who have, over the years, been lumped with more and more tasks, according to Public Services International, a global trade union federation, which helped the women CHWs in Pakistan, Nepal and India come up with a Charter of Demands to “address injustices and advocate for better working conditions”.
According to Jeni Jain Thapa, PSI’s project organiser in Nepa, the FCHVs “have no fixed working hours and must be on standby 24/7”.
The same is the case with the LHWs, said Musarrat Basharat, an LHW and the general secretary of the Punjab LHW’s Union. “Whatever time of the day or night it is, we must accompany a woman in labour to the health centre and be with her till she delivers. Same with a sick child. If the baby has diarrhoea and is dehydrated, we must rehydrate and be with the family for six hours until the child is out of danger. We are not shirking from our duty, but at least pay us for overtime or make some provision for it,” she said.
However, of the CHWs in the three countries, over 100,000 LHWs have won significant gains in getting themselves recognised as workers, securing a wage and registering their unions, Kannan Raman, secretary PSI, South Asia: “In Nepal and India, they are considered volunteers and not offered decent wages or better working conditions.”
“It took us 20 years to get ourselves noticed when the Supreme Court of Pakistan asked the government to bring us into the fold of formal work and make us permanent employees in 2014,” said Haleema Leghari, central president of All Sindh Lady Health Workers and Employees Union, working as a supervisor in the LHW programme.
But even after nine years, they continue working without a job structure or rules that go with that. “We rejected the service structure made for us as it was found to be discriminatory,” said Leghari, adding: “Recognition from the government is mere lip service.”
Even for those who started in 1994, like Arain and Leghari, who have become supervisors, their grades have been marginally improved from Grade 5 (which is for LHWs) to Grade 7 (which is for the supervisor). “While in other sections of the health departments, those who have worked as many years as us and are as educated as us have reached Grade 14; why have we not been upgraded?” Arain asked.
Although their salary was increased by 35 percent in June, Leghari said: “We do not want these ad-hoc increments; we want promotions like other government servants are promoted based on work performance, education and years of service, as these impromptu increments can also be taken back anytime.”
In addition, she said that those who have retired after attaining 60 years of age, are sick, or have died should be compensated. They or their families should be paid the pension in arrears,” she added. Today, the LHWs want the 20 years of contract work to be accounted for, which they say “everyone seems to have forgotten”.
According to Leghari, in other government departments, when an employee retires or meets with an accident, is sick or dies, a family member gets the job in that department. “We are missing out on these benefits because the rules have not been approved in the absence of a service structure,” she said.
“Their main demand is fool-proof security,” said Mir Zulfiqar Ali, executive director of Workers Education and Research Organisation. “You know so many LHWs have been killed by extremists,” he said. His organisation is working with the LHWs and training them about labour rights, health protection especially during crises and pandemics, and workplace safety and how to lobby effectively with the government to get their demands accepted, coordinating the PSI CHW project in Pakistan.
Siddiqi’s monthly payment is now Rs 44,000 from Rs 37,000 since June, but given the skyrocketing food, electricity and fuel prices, she said this was certainly not enough for a single mother with two school and college-going kids.
“The provincial health departments have time to meet all the international NGOs and donor agencies, but for holding a meeting to address our grievances, they can never find time,” said Arain.
“The invaluable work community health workers do work that has delivered immeasurable value to communities and public health, is not valued, simply because it is carried out by women, and women’s care work is routinely de-valued, even when it saves lives”, explained Kate Lappin, the Asia Pacific regional secretary for PSI.
With new climate catastrophes imminent, Lappin said Pakistan will need the services of LHWs even more, as was proved during the pandemic and the 2022 floods that disrupted the already fragile health system. “They are the first line of defence in a crisis.” She was in Pakistan recently and met with LHWs from some remote parts of Pakistan. “It was clear that they are often the only source of support to women in the most underserviced areas.”
MONTEVIDEO, Uruguay, Oct 10 (IPS) – Mexico’s Supreme Court recently declared abortion bans unconstitutional, effectively decriminalising abortion throughout the vast federal country, so far characterised by a legislative patchwork.
The ruling came in response to a lawsuit filed by a civil society organisation, Information Group on Reproductive Choice. It forces the Federal Congress to repeal the Federal Penal Code articles that criminalise abortion. Effective immediately, those seeking abortions and those providing them can no longer be punished for doing so. The ruling also enshrines the right to access abortion procedures in all institutions of the federal health system network, even in states where the crime of abortion remains on the books.
Global trends
Mexico is part of a global, long-term trend of progress in sexual and reproductive rights. According to the Center for Reproductive Rights, the vast majority of countries that have changed their national abortion laws over the past couple of decades have made them less restrictive. Only four countries have gone the other way: El Salvador, Nicaragua, Poland and the USA.
Several Latin American countries have been swept by the ‘green tide’ that originated in Argentina, increasingly liberalising abortion laws. Before the 2010s, abortion was legal in only one Latin American country, Cuba. It was legalised in Uruguay in 2012, and eight years later in Argentina. Colombia decriminalised abortion in February 2022, and other countries, such as Chile and Ecuador, have since made it legal on limited grounds, notably when pregnancy is a result of rape – which women’s rights organisations see as a milestone on the road to full legalisation.
Globally, abortion is currently legal on request in 75 countries, often until 12 weeks into pregnancy. Around a dozen more allow it for broad socio-economic reasons. Many more permit it for specific reasons such as health grounds or to save a pregnant person’s life.
But abortion remains banned under any circumstances in 24 countries, and overall 40 per cent of women of reproductive age live under restrictive abortion laws. These restrictions have a significant impact on women: it’s estimated that unsafe abortions costs the lives of 39,000 women and girls every year.
A legislative patchwork
The trend towards decriminalisation in Mexico kicked off in 2007 in Mexico City, and it took 12 years for another state, Oaxaca, to follow its lead. Change accelerated in recent years, with Hidalgo and Veracruz legalising abortion in 2021.
In September 2021, the federal Supreme Court issued its first-ever decision on abortion rights, unanimously recognising a constitutional right to safe, legal and free abortion services within a ‘short period’ early in pregnancy, and on specific grounds later. The ruling came in response to a lawsuit against the state of Coahuila, which imposed prison terms of up to three years for voluntary abortion.
Although this ruling only applied to Coahuila, it had a wider impact: judges in other states were no longer able to sentence anyone for the crime of voluntary abortion in the early stages of pregnancy.
Two days after this judgment, the Supreme Court addressed another lawsuit concerning the state of Sinaloa, issuing a ruling that declared it unconstitutional for state laws to redefine the legal concept of personhood by protecting ‘human life from conception’. And soon after, it declared invalid the principle of conscientious objection for medical practitioners in the General Health Law. A couple of months earlier it had ruled unconstitutional the time limits set by some states for abortions in cases of rape.
By the time of the Coahuila ruling, only four federal entities allowed abortion on demand up to 12 weeks. But several have changed their laws since, and by the time of the latest Supreme Court ruling, abortion on demand was already legal in 12 of Mexico’s 32 states. All states also allowed abortions for pregnancies resulting from rape, most allowed abortion when necessary to save a pregnant person’s life, and several allowed it in cases of risks to a pregnant person’s health or severe congenital foetal abnormalities.
Regional experience however suggests that making abortion conditional on exceptional grounds that must be proven tends to result in denial of access. Additionally, in Mexico, access by particularly vulnerable women has often been restricted through resistance in bureaucracies and medical institutions, even in states where abortion is legal.
Now Congress has until the end of its current session, which runs until 15 December, to amend the Penal Code clauses that criminalise abortion. But even after this, abortion will continue to be a state-level crime in 20 states. This means that abortion complaints will continue to be filed in those states. In most cases judges will ultimately have to dismiss the charges – but women will continue to be subjected to unnecessary barriers and uncertainty. For this reason, the women’s rights movement is pushing locally for decriminalisation in every Mexican state.
Effective access the next struggle
Mexican women’s rights groups are getting ready for what promises to be a long battle for effective access. They feel confident, for now, that thanks to decades of hard work public opinion is on their side. But they know that, while there may be less up-front resistance than before, there are still powerful forces against change. Resistance manifests in the imposition of barriers to prevent effective access to what is now recognised as a right, particularly for people from the most excluded groups in society.
Denial of access can take many forms: long waiting times, the need for multiple doctors’ appointments and parental or marital consent, disinformation and the extension of conscientious objection from individual health personnel to entire institutions.
Sexual and reproductive health, including abortion procedures, is basic healthcare and should be easily accessible to all. Mexican feminists know this, and will continue fighting to change both policy and minds so nobody is denied access to their rights.
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